With only a few days left to enroll through health insurance marketplaces, the administration is struggling to provide full support in the enrollment process. Even after repeated promises and several attempts at fixing a stumbling site, the Obama administration is still a long way off its target mark for enrollments and signups.
Needless to say, most of the issues are technical in nature, connected or associated with healthcare.gov. We uncovered the four critical technical measures that can save Obamacare, even at this stage.
• Federal Marketplace Fixes – No points for guessing this one – the most important fix that is required at the moment is for the federal marketplace. True, the health insurance exchange is performing a lot better than the day it was launched on October 1, but it is still a long way off the targeted mark. Only 137,000 enrollments were made up to the week before Christmas, and lot of uninsured are still without insurance. When you consider the bigger picture, this number is nothing in front of the millions waiting to get insured. These fixes will make the website smoother and easier to navigate, making enrollments all the more smoother. A side benefit will be for the exchange navigators, who are trying extremely hard to get as many enrolled as possible, but are being limited by the unstable marketplace.
• Direct Enrollment Functionality for Private Exchanges – Another technical fix would be the direct enrollment functionality. Basically, the direct enrollment functionality allows private exchanges to bypass the federal marketplace interface and get all the required data, subsidy information, and interface with federal data hub to process enrollments. The consumers only need to interface with one website, the health payor’s private exchange, to get enrolled, thereby reducing the switching from one system to another. With this functionality, consumers can directly go through private health insurance exchange, which are performing flawlessly, to get their insurance and avoid the federal pitfall altogether. Naturally, this move can eliminate a lot of stress from the federal marketplace, drive business to private benefits exchanges and give a smooth experience to users, resulting in a win-win situation for everyone.
• Eliminate Backdoor Errors and Problems – The backdoor transaction errors, popularly known as the 834 error, was an unforeseen problem that the Obamacare implementation experts have been facing since the launch day. Arguably, this is one of the biggest irritants in the whole enrollment process – it lets an enrollment go through till the very end, only to provide incorrect data to the health payors at the backend, thus resulting in an ineligible enrollment without the knowledge of customers. So, people who go through the process aren’t given a guarantee of successful enrollment, courtesy the 834 problem. Even now, after all the fixes, there is about a 5 to 10 percent probability that an 834 transaction will occur. The administration needs to fix this ASAP as this might increase the number of enrollments further, especially when you consider that 5 to 10 percent of a few million is a large number.
• Allow Canceled Health Policies to Coexist – While this is not entirely a technical fix, the co-existence of health policies, which are not compliant with ACA might require some technical work in the system. On December 19, the administration did announce that people whose policies have been canceled will be allowed to buy catastrophic coverage and will be exempt from tax penalties for not having insurance in 2014. It also extended, for one month, an expiring federal program for people with cancer, heart disease and other serious illnesses.
While these measures are not new for the government, and its technical team has been working on all these aspects in the recently popular ‘tech-surge’ initiated by President Obama, the administration definitely needs to speed up its efforts on delivering these fixes as soon as possible. In few weeks from now, the pressure on these marketplaces will increase, and instead of affecting an extension of the final March 31 deadline, the government can, and should, push for a quicker implementation of the above technical fixes.
If the technical fixes go as planned, the Obamacare health insurance marketplaces still have a very good chance of becoming the de-facto standard of online marketplace experience for health insurance.